Prescription Required 
Formulation : 
Description
Indications
Dihydroergotamine is utilized for the treatment of migraine headache attacks, providing relief from headache pain and associated symptoms like sensitivity to light or sound. Its prompt administration facilitates a quicker return to normal activities and may reduce the necessity for other pain medications. Dihydroergotamine belongs to a class of drugs called ergot alkaloids. Its mechanism of action involves potentially narrowing the blood vessels in the brain and may also block other pain pathways in the brain.
Uses and Dosage
Learn and follow all preparation and usage instructions provided in the product package. If any information is unclear, consult your doctor or pharmacist.
This medication is available in individual nasal spray vials, with each vial containing enough medication for a single migraine attack. Do not exceed 4 sprays for a single attack. Before using each nasal spray vial, prime the pump by spraying it four times into the air, away from the face.
At the first sign of a migraine, administer this medication into the nostrils. Do not inject it. Administer one spray into each nostril. Refrain from tilting your head back, sniffing through your nose, or blowing your nose during or immediately after spraying. Administer another spray into each nostril 15 minutes after the initial sprays, or as directed by your doctor. Following the use of the medication, lie down and relax in a quiet, darkened room. The maximum number of sprays for a single attack is 4 (two in each nostril). Relief should be felt within 30 minutes of using this medication.
Dosage is based on your medical condition and response to treatment. Consult your doctor regarding how often you can use this medication for treating your migraine headaches. Do not exceed the prescribed dose or use it more frequently or for a longer duration than recommended. Increasing the dosage will not expedite improvement, and it may elevate the risk of side effects.
This medication is most effective when used at the onset of the headache. Delaying its use until the headache worsens may reduce its efficacy. Utilize it only as needed for treating migraine attacks when they occur; it is not intended for long-term daily use.
If you are new to this medication and have risk factors for heart disease (refer to Precautions), your doctor may monitor you for rare but serious side effects (such as chest pain) when you take the first dose. In some cases, your doctor may advise you to take the initial dose in their office.
If you are also taking “triptan” or other ergot medications (such as sumatriptan, methysergide), wait 24 hours before and after taking dihydroergotamine. Consult your doctor or pharmacist for specific details and advice on timing your doses of these medications.
Using drugs for migraine attacks on 10 or more days each month may exacerbate headaches (medication overuse headache). Adhere to the prescribed frequency and duration of medication use. Inform your doctor if you feel the need to use this medication more often, if it is not as effective, or if your headaches worsen.
Side Effects
Some side effects may occur that usually do not need medical attention:
- burning or tingling sensation, dryness, soreness, or pain in the nose
- change in sense of taste
- diarrhea
- dizziness
- dry mouth
- headache
- increased sweating
- muscle stiffness
- nausea and vomiting
- sudden sweating and feelings of warmth
- sensation of burning, warmth, or heat
- sore throat
- sleepiness
- stuffy or runny nose
Inform your healthcare provider immediately if you experience any serious side effects:
- chest pain or tightness
- cough
- fever
- irregular heartbeat
- itching of the skin
- numbness and tingling of the face, fingers, or toes
- pain in the arms, legs, or lower back
- pain in the back, chest or left arm
- pale bluish-colored or cold hands or feet
- sneezing
- sore throat
- trouble breathing
- weak or absent pulses in legs
Caution
- Before using dihydroergotamine, inform your doctor or pharmacist if you are allergic to it or to other ergot alkaloids (such as ergotamine, methysergide, bromocriptine), or if you have any other allergies. Inactive ingredients in the product may cause allergic reactions or other complications.
- Provide your medical history to your doctor or pharmacist, especially if you have a history of heart disease, stroke, high blood pressure, blood circulation disease, a severe blood infection (sepsis), bowel disease (such as ischemic bowel syndrome), kidney disease, liver disease, headaches with unusual symptoms, or certain types of headache (hemiplegic/basilar), recent blood vessel surgery, or nasal problems.
- Inform your doctor if you have risk factors for heart disease, including high blood pressure, high blood cholesterol, obesity, diabetes, smoking/tobacco use, or a family history of heart disease. If you are at high risk for heart disease, your doctor may want to check your heart before prescribing dihydroergotamine and may administer your first dose in the office.
- This medication may cause dizziness. Avoid activities requiring alertness until you can perform them safely. Limit alcoholic beverages, and if you use marijuana, discuss it with your doctor.
- The use of tobacco/nicotine products while on this medication can increase the risk of serious side effects such as heart problems (chest pain, fast/slow/irregular heartbeat) and reduced blood supply to the brain/hands/feet. Refrain from using tobacco while taking this medication, and if you smoke, talk to your doctor about quitting.
- Inform your doctor if you are pregnant or planning to become pregnant, as using dihydroergotamine is not advised during pregnancy. Dihydroergotamine may harm an unborn baby. If you become pregnant, discuss the risks and benefits of this medication with your doctor.
- This drug may pass into breast milk. Due to the potential risk to the infant, breastfeeding is not recommended while using this drug and for 3 days after the last dose. Consult your doctor before breastfeeding.
Form and Strength
Migranal Nasal Spray is available in the following forms and strengths:
- Migranal Nasal Spray ampule:
- 4 mg/ml
FAQ
Does Migranal Nasal Spray cause drowsiness?
Migranal Nasal Spray doesn’t commonly make people feel drowsy or sleepy.
How fast does Migranal Nasal Spray work?
This depends on which form of dihydroergotamine you’re using. Migranal Nasal Spray lowers pain within 2 hours in most patients.
Resources
- https://www.goodrx.com/dihydroergotamine-mesylate/what-is#faqs
- https://www.mayoclinic.org/drugs-supplements/dihydroergotamine-nasal-route/side-effects/drg-20063447
- https://www.webmd.com/drugs/2/drug-5527/migranal-nasal/details
- https://www.healthlinkbc.ca/medications/dihydroergotamine-nasal
- https://www.drugs.com/mtm/migranal-nasal.html
